Outline:

The Territory of Depression:

The Territory of Depression
WHO predicts that by 2010 depression will rank second to cardiovascular disease in economic and personal costs.
Chronic illness, typically with several recurrences

Rates of Depressive Relapse Over 15 Years:

Rates of Depressive Relapse Over 15 Years

Risk Factors For Depressive Relapse:

Risk Factors For Depressive Relapse
Number of Past Episodes of Depression
Family History of Depression
Significant Losses/Stressors
Cognitive Reactivity to Sad Moods

Qualities of Relapse-Related States of Mind:

Qualities of Relapse-Related States of Mind Automatic
- Little intentional control of attention
- Avoidant or suppressive
Ruminative and Centered on Self
-Strong identification with thoughts and feelings
-Strongly correlated with the past # of depressions
-Gender differences in rumination correlate with gender distribution in depression

Rumination Can Be Seen To Be Emotional Wisdom:

Qualities of Relapse-Related States of Mind:

Qualities of Relapse-Related States of Mind Content
- “In order to be happy, I must be……”
- “Admitting to your mistakes is a sign of weakness”
- “If others look to me for guidance, it would make me feel important”
Process
- What does feeling this way say about me?
- Why is this (sadness) happening to me?
- How can I change this (sadness)?

Mindfulness-Based Cognitive Therapy:

Mindfulness-Based Cognitive Therapy
An Integration of MBSR and Cognitive Therapy
A Blend of Acceptance and Change models
Customized for Depression

Mindfulness-Based Stress ReductionMBSR:

Mindfulness-Based Stress Reduction MBSR University of Massachusetts Medical Center,
Stress Reduction Clinic,1979
Jon Kabat-Zinn, Ph.D., founder
8 Week Program
Participants with a wide range of medical problems, including chronic pain, anxiety disorders, depression, hypertension, heart disease and cancer.
Program outlined in the book “Full Catastrophe Living, Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness”

A Definition of Mindfulness:

Mindfulness means paying attention,
in a particular way,
on purpose,
in the present moment,
and non-judgmentally
Jon Kabat-Zinn A Definition of Mindfulness

How Does Cognitive Therapy Prevent Depressive Relapse?:

How Does Cognitive Therapy Prevent Depressive Relapse? Teaches Patients in Depressed Mood to:
-Switch out of a habitual cognitive mode of mind
-Decenter - thoughts are not necessarily me and not necessarily true
-Turn towards the Difficult
-Change Degree of Belief

3 Minute Breathing SpaceProvides a way to step out of automatic pilot mode and reconnect with the present moment:

3 Minute Breathing Space Provides a way to step out of automatic pilot mode and reconnect with the present moment
AWARENESS
Acknowledge &amp; register your experience, even if it is unwanted
GATHERING
Bring full attention to the breath, as an anchor
to awareness &amp; stillness
EXPANDING
Awareness of the body as a whole, your posture
and facial expression

Rates of Depressive Relapse for Patients with 3 or More Past Episodes:

Meditation and the Brain:

PET Scans and Meditation:

PET Scans and Meditation Dorsal Lateral Prefrontal Cortex
Left associated with feelings of happiness &amp; well-being and approach behaviours
Right associated with feelings of distress and avoidance behaviours
Meditation
Increased left sided anterior activation compared to controls
Over 8 weeks participants began to shift in the same direction as Buddhist monks

Summary:

Summary MBCT was designed to reduce relapse by helping patients disengage from ruminative thinking triggered by sad moods.
MBCT helps patients shift their relationship to thoughts/ sensations/feelings without trying to change belief in thought content.
It is ideal for patients in recovery because depression need not be present for them to practice
Shown to reduce relapse rate by 50% in patients with recurrent depression.